1. Tobacco 101
[Insert your name
and information here] 1

2. Overview Traditional tobacco Commercial tobacco Smokeless tobacco
Tobacco & Cancer
Tobacco & Diabetes
Tobacco & Secondhand smoke 2

3. Traditional Tobacco Stories
Many indigenous nations have traditional stories of how tobacco was introduced to their communities.
Many stories emphasized the sacredness of the plant and its powers to both heal if used properly and to harm us if used improperly!
Some say that the original tobacco was discovered about 18,000 years ago. 3

4. Traditional Tobacco Uses
Tobacco was used by our Medicine People for both healing and blessings.
Used as a smudge… to ward off pests when the people went out to hunt and gather (the original version of “OFF”) because it contains nicotine, a natural pesticide.
Given as a gift when welcoming guests to the community & as an offering to those requested to pray or share their wisdom. 4

5. Traditional Vs. Commercial
Tobacco
TRADITIONAL
COMMERCIAL
Smoked in a pipe for ceremonial purposes
Used as an offering to a healer, elder or other person as a sign of respect or thanks
Medicinal tobacco was often used as a painkiller
Deliberate targeting of specific consumer groups
Premeditated and conscious addition of chemicals that lead to addiction
Scarcely contains actual tobacco 5

6. Commercial Tobacco Contents
4000 Chemicals
40 Cancer causing agents
500 Poisons 6

7. Nicotine Poisonous More addictive than cocaine and heroine
So powerful that farmers can’t use it to kill insects
Legal addiction
Use results in emotional dependence
Mood leveler
Users rely on it to control emotional responses to everyday life 7

8. Carbon Monoxide The compound in car exhaust that causes death
Causes shortness of breath
Reduces the amount of oxygen blood can carry 8

9. Tar Sticky Residue that stains the fingers and teeth.
Contains benzopyrene, one of the deadliest cancer causing agents known. 9

10. Chemicals Acetone: fingernail polish remover
Ammonia: floor/toilet cleaner
Cadmium: batteries
Arsenic: rat poison
Methane: cow manure fumes
Formaldehyde: preserver of dead bodies 10

11. Metals Aluminum Magnesium Zinc Silicon Titanium Silver Lead Copper
Mercury
Heavy metals 11

12. Nicotine Hard Habit to Quit
On a milligram for milligram basis, is 10 times more potent than heroin as an addictive substance
Smoking is an over-learned behavior
Pack/day smoker estimates
6 doses (puffs)/cigarette
20 cigarettes per day
= 43,800 doses per year!
Few behaviors occur more often. . .
Breathing
Blinking 12

13. Withdrawal Symptoms Nicotine Hard Habit to Quit Anxiety 87% *
Irritability 80% *
Difficulty Concentrating 73% *
Restlessness 71%
Tobacco
Cravings 62%
Gastrointestinal Problems 33%
Headaches 24%
Drowsiness 22%
* Pharmacotherapies can help address these problems 13

14. Tobacco Health Effects14

15. Tobacco Health Effects
CDC SAMMEC, MMWR 1993; 42:645-9. 15

16. Tobacco
Facts & Stats
40% of all AN/AN deaths can be attributed to commercial tobacco use
50% of AI/AN teens reported some type of cigarette use (highest rate in the nation, out of all ethnic populations and age groups)
21% of AI/AN teens reported using smokeless tobacco
Teens are 3 times more likely to smoke if parent or sibling smokes
Tobacco use among American Indian Adolescents: protective and risk factors. J. of Ad. H., 2001 16

17. Tobacco Facts & Stats AI/AN’s 40.8% African Americans 22.4%
Whites %
Hispanics %
Asian American/ % Pacific Islanders
National Health Interview Survey, US 2001 17

18. Tobacco
Facts & Stats
U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Groups- African
Americans, American Indian and Alaska Natives, Asian Americans Pacific Islanders, and Hispanics: A Report
Of the Surgeon General. (Atlanta: U.S. Department of Health and Human Services, Centers for Disease ControlAnd Prevention, 1998.) 18

19. Tobacco
Facts & Stats
85% of teenagers who smoke two or more cigarettes completely, and overcome the initial discomforts of smoking, will become regular smokers.
In a study of high school seniors, only 5% of those who smoked believed they would still be smoking two years after graduation. In fact, 75% were still smoking eight years later.
One-third to one-half of young people who try cigarettes go on to be daily smokers. 19

20. Tobacco
Costs
Every pack of cigarettes sold in the U.S. costs the community $7.18 in medical care costs and lost productivity
IHS estimates $200 million is spent each year to treat tobacco related diseases
$75 billion in direct medical costs associated with tobacco use each year in U.S.
$82 billion unrealized due to loss of productivity as a result of tobacco abuse 20

21. Tobacco Individual Costs
A pack a day habit…
1 Year = $1, Years = $16, Years = $33,600 21

22. Tobacco
Facts & Stats
“If not one single young person started smoking from this day forward these losses [more than 400,000 deaths per year] would still continue unabated for 30 years.”
C. Everett Koop (US Surgeon General ) 22

23. Smokeless Tobacco Facts & Stats
Chew, Snuff, plug, leaf, and dip are all forms of smokeless tobacco
If you hold the average-sized dip in your mouth for 30 minutes you get as much nicotine as you would from 2-3 cigarettes
American Indian teenage girls have the highest prevalence rates of spit tobacco
43 % of Indian youth in the Northwest use spit tobacco 23

24. Smokeless Tobacco Facts & Stats
Contains 28 cancer-causing chemicals
One can of Copenhagen is equal to 3 packs of cigarettes
Snuff dippers consume on average 10 times more cancer-causing substances (nitrosamines -- chemicals from the curing process) than cigarette smokers
Source: American Cancer Society. (1999) Quitting Smoking. Atlanta, GA. 24

25. Effects of Smokeless Tobacco
Tooth Abrasion
Gum Disease
Gum Recession
Heart Disease and Stroke
Cancer in the mouth, pharynx (voice box), esophagus and pancreas. 25

26. Effects of Smokeless Tobacco
Increased heart rate
Increased blood pressure
Bad breath
Reduced sense of smell 26

27. Tobacco & Cancer
Lung cancer is the number one cause of cancer death among Indian women
Women’s death rates due to lung cancer have risen 600% since 1950
About 90% of all lung cancer deaths are attributable to smoking
Chewing tobacco and snuff contain 28 different carcinogens
Source: National Cancer Institute. (1998) Questions and Answers About Smokeless Tobacco and Cancer, Bethesda, MD. 27

28. Tobacco & Cancer
Smoking is a major cause of cancers of the oropharynx (base of the tongue) and bladder among women.
Women who smoke have increased risks for cancers of the pancreas and kidney.
Larynx and esophagus cancer rates are also elevated. 28

29. Tobacco & Cancer Healthy lungs Small cell cancer in Smoker’s lung
Cancerous tumor in the lung 29

30. Tobacco & Cancer
Research shows that smokers infected with human papillomavirus have greater risk of developing invasive cervical cancer than nonsmokers with the virus.
Indian women have cervical cancer rates 3.5 times the national average. Tobacco is one of the behavioral factors considered to elevate the risk of cervical cancer.
Dr. Carolyn D Runowicz, a gynecologic oncologist, and member of the Am cancer society’s national board of directors. The chemicals in cigarettes may weaken the ability to fight off the infection. 30

31. Tobacco & Diabetes
Smoking and Diabetes both reduce the amount of oxygen reaching your bodily tissues, resulting in poor circulation.
Smoking raises your blood sugar level making it harder to control your diabetes.
Of people with diabetes who need amputations, 95% are smokers.
Smoking cuts the amount of oxygen reaching tissues. The decrease in oxygen can lead to a heart attack, stroke, miscarriage or stillbirth
People with diabetes are at risk for blood vessel injury, which may be severe enough to cause tissue damage in the legs and feet.
Smoking increases your cholesterol levels and the levels of other fats in your blood, increasing your risk of a heart attack
Diabetes cuts the amount of oxygen reaching your bodily tissues, resulting in poor circulation.
Diabetes causes blood vessels of the feet and legs to narrow and harden, resulting in nerve and tissue damage (neuropathy) sometimes leading to amputation.
Neuropathy lessens your ability to feel pain, heat or cold. Loss of feeling means foot injuries may go un-noticed and serious infection may set in.
Poor circulation lessens the body’s ability to fight infection and to heal. 31

32. Tobacco & Diabetes
Nicotine is a vessel constrictor, reducing the body’s blood flow. Smoking increases cholesterol levels and hardens arteries.
Diabetes increases cholesterol levels and the levels of some other fats in your blood.
The combined cardiovascular risks of smoking and diabetes is as high as 14 times those of either smoking or diabetes alone. 32

33. Tobacco & Diabetes
Together, diabetes and tobacco use make it twice as likely that you will develop heart and blood vessel disease.
People with diabetes who smoke are 3 times more likely to die of cardiovascular disease than are other people with diabetes.
Deaths from heart disease in women with diabetes have increased 23% over the past 30 years compared to a 27% decrease in women without diabetes.
CVD is a major complication and the leading cause of premature death among people with diabetes—at least 65 percent of people with diabetes die from heart disease or stroke.1
Adults with diabetes are two to four times more likely to have heart disease or suffer a stroke than people without diabetes.
Middle-aged people with type 2 diabetes have the same high risk for heart attack as people without diabetes who already have had a heart attack.2, 3
Relatively small improvements in blood glucose (sugar), lipids, and blood pressure values result in decreased risk for diabetes complications. 33

34. Secondhand Smoke
Smoke breathed out by a smoker and smoke from the burning end of cigarettes, cigars, pipes
Composed of nearly 4,000 different chemicals and over 150 toxins including carbon monoxide 34

35. Children & Secondhand Smoke
38% of children aged 2 months to 5 years are exposed to SHS in the home.
Up to 2,000,000 ear infections each year
Nearly 530,000 doctor visits for asthma
Up to 436,000 episodes of bronchitis in children under five
Up to 190,000 cases of pneumonia in children under five
More upper respiratory infections
More bronchitis and pneumonia
More ear infections and hearing problems
Higher rate of SIDS
More cases of asthma
More severe symptoms in children who already have asthma 35

36. Children & Secondhand Smoke
Coughing and wheezing
Asthma
Sore throats and colds
Eye irritation
Hoarseness 36

37. Pregnancy & Secondhand Smoke
Pregnant women exposed to ETS 6 hours a day pass carcinogens to the blood of unborn
ETS for 2 hours a day causes 2 times risk of low birth weight
Miscarriage
Prematurity
Low birth weight
Sudden Infant Death Syndrome (SIDS)
Children of smokers have higher cholesterol levels, more prone to heart disease, more susceptible to respiratory infections, asthma, ear infections, and anemia 37

38. What You Can Do… If you smoke quit as soon as possible!
Do not allow smoking inside your home or car – protect others from Secondhand smoke.
Get involved with tobacco awareness campaigns – let others know about the risk!
Children of smokers have higher cholesterol levels, more prone to heart disease, more susceptible to respiratory infections, asthma, ear infections, and anemia 38

39. When You Quit… 39 Within 20 Minutes: Blood pressure drops to normal
Pulse rate returns to normal
Body temperature of hands and feet increases to normal
Within 8 Hours:
Carbon Monoxide level in blood drops to normal
Oxygen level in blood increases to normal
Smoker's breath disappears
Within 24 Hours:
Your chance of a heart attack decreases.
Within 48 Hours:
Nerve endings start to re-grow
Your ability to smell and taste is enhanced 39

40. When You Quit… 40 Within 72 Hours:
Bronchial tubes relax making it easier to breathe.
Lung capacity increases making it easier to do physical activities
Within 2 weeks - 3 months:
Circulation improves
Walking becomes easier
Lung function increases up to 30 %
Within months:
Coughing, sinus congestion, fatigue, shortness of breath decrease
Energy level increases
Cilia re-grow in lungs, increasing the ability to handle mucus, clean lungs, reduce infection  40

41. When You Quit… Within One Year:
Risk of coronary heart disease is half that of a smoker
Within Two Years:
Heart attack risk drops to near normal
Within 5 Years:
Lung cancer death rate for average pack-a-day smoker decreases by almost half
Stroke risk is reduced
Risk of mouth, throat and esophageal cancer is half that of a smoker 41

42. When You Quit… Within 10 Years:
Lung cancer death rate is similar to that of a person who does not smoke.
The pre-cancerous cells are replaced.
Within 15 Years:
Risk of coronary heart disease is the same as a person who has never smoked. 42

43. Thank you!
Questions
Comments
Stories 43